Individual
DR. ANGELINA IBIWARI AYOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11706 FALLBROOK DR, HOUSTON, TX 77065-3510
(832) 912-6282
(281) 807-0457
Mailing address
11706 FALLBROOK DR, HOUSTON, TX 77065-3510
(281) 955-3377
(281) 807-0457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K9218
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082HD
BLUE CROSS BLUE SHEILD
TX
01
—
0275391-013
CIGNA PROVIDER NUMBER
TX
01
—
7999253
AETNA PROVIDER NUMBER
TX
Enumeration date
08/17/2006
Last updated
07/09/2021
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